11D0993810 CLIA NUMBER - STONE MOUNTAIN DIALYSIS CENTER LLC FRESENIUS MEDICAL CARE STONE MOUNTAIN

Laboratory Demographics

  • CLIA Code: 11D0993810
  • Facility Name: STONE MOUNTAIN DIALYSIS CENTER LLC FRESENIUS MEDICAL CARE STONE MOUNTAIN
  • Facility Address: 5723 MEMORIAL DRIVE
    STONE MOUNTAIN, GA
    ZIP 30083
  • Facility Phone: 678 836-0251
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CLARA TRUESDELL
  • NPI Number: 1558473371
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0993810
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name STONE MOUNTAIN DIALYSIS CENTER LLC FRESENIUS MEDICAL CARE STONE MOUNTAIN
Street 5723 MEMORIAL DRIVE
City STONE MOUNTAIN
State GA
ZIP 30083
Phone 678 836-0251
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CLARA TRUESDELL

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This page was last updated on: 9/29/2025